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Polio Is Back—Do You Need Another Vaccination?

The first case of polio in the U.S. in nearly 10 years detected in a New York City suburb this summer has raised alarms among public health officials. Ever since the news broke, our primary care doctors in Delray Beach have been receiving calls from some of our patients, worried that they may be at risk.

Those who remember the horrific outbreaks in the 1940s-50s have good reason to be concerned: pictures of people—many of them children—confined to iron lungs to help them breathe; memories of parents crawling along the floor because they were paralyzed; young children in leg braces struggling to walk; adults with one or both legs permanently shriveled (atrophied) following recovery.

Unwelcome return

The return of the virus in New York has triggered fears of another outbreak. A team from the Centers for Disease Control and Prevention (CDC) has traveled to Rockland County, New York, the site of the one reported case. They are “quite nervous” that polio “could mushroom out of control very quickly and we could have a crisis on our hands,” one community health leader who met with the team told CNN.

According to the CDC, polio has been circulating undetected in the New York City metropolitan area for months after an unvaccinated individual brought the virus back from abroad. The infected person, also unvaccinated, became paralyzed in June, although they are now reported to be able to stand (but not walk).

After that person’s case was confirmed, reviews of area wastewater found 21 sewage samples that tested positive for polio: 13 in Rockland County, New York, and eight in nearby Orange County.

The CDC also reported three other people are suspected of having the virus, but they have tested negative so far.

About Polio

There is no cure for polio, technically known as poliomyelitis. 

According to the CDC, most people who get infected with poliovirus will not have any visible symptoms. About 25 percent will have flu-like symptoms that can include:

  • sore throat
  • fever
  • tiredness
  • nausea
  • headache
  • stomach pain

These symptoms usually last two to five days, then go away on their own.

Poliovirus is very contagious, and spreads through person-to-person contact, living in an infected person’s throat and intestines. An infected person can spread the virus to others immediately before and up to two weeks after symptoms appear, or live for weeks in an infected person’s intestines. And, as with the SARS-CoV-2 coronavirus, it can be spread by those who never experience symptoms.

Complications

A smaller proportion of people with poliovirus infection will develop other, more serious symptoms that affect the brain and spinal cord:

Meningitis, an infection of the covering of the spinal cord and/or brain, occurs in about one to five percent of people with poliovirus infection, depending on the type of virus the person is exposed to.

Paralysis, an inability to move parts of the body, or weakness in the arms, legs, or both, occurs in one out of 200 to one out of 2,000, depending on the type of virus.

Paralysis is the most severe symptom of poliovirus, because between two-ten percent of people with polio die when the virus affects their ability to breathe. The CDC also estimates that between 25-40 percent of polio survivors will develop the debilitating set of symptoms known as post-polio syndrome, including muscle weakness, joint pain, and mental and physical fatigue.

How it got here

The New York Times reported that the Rockland patient is a man from the Orthodox Jewish community, according to unnamed local elected officials. The community paper New York Jewish Week also quoted multiple sources that confirmed this report.

Rockland County is home to an ultra-Orthodox Jewish community, CNN reported, in which vaccination rates for all diseases have historically been very low.

“There are a number of individuals in the community that have been infected with poliovirus,” José Romero, director of the CDC’s National Center for Immunization and Respiratory Diseases, told CNN.

“They are shedding the virus,” he said. “The spread is always a possibility because the spread is going to be silent.”

“Low vaccination coverage in the patient’s county of residence indicates that the community is at risk for additional cases of paralytic polio,” CDC officials wrote in a statement. “Even a single case of paralytic polio represents a public health emergency in the United States.”

Much of the rest of the religious Jewish community in Rockland County has joined efforts to educate and persuade those who refuse to vaccinate, CNN reported.

Do you need a vaccine?

In the late 1940s, polio outbreaks disabled an average of 35,000 Americans a year. The advent of effective vaccines nearly wiped out the disease in the U.S.

The CDC says the most adults residing in the U.S. are presumed to be immune to poliovirus from previous routine childhood immunization and have only a small risk of exposure to poliovirus in this country.

But if you’re unvaccinated or incompletely vaccinated, or at higher risk for exposure to the poliovirus, you should receive a vaccine now.

Higher risk situations include:

Otherwise, you should be safe. If you’re still unsure, though, be sure to give us a call.

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